Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $1,000.00 / $17,782.79	Facility		$123.03	$1,000.00	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $102.33 / $371.54	Professional		$53.70	$102.33	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $93.33	Professional		$83.18	$83.18	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $125.89 / $239.88	Professional		$69.18	$125.89	$239.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $141.25 / $263.03	Facility		$85.11	$141.25	$263.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $138.04 / $239.88	Professional		$85.11	$138.04	$239.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $181.97 / $190.55	Facility		$128.82	$181.97	$190.55
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $128.82	Facility		$123.03	$123.03	$128.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $138.04 / $234.42	Professional		$75.86	$138.04	$234.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,122.02 / $2,137.96	Facility		$776.25	$1,122.02	$2,137.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $125.89 / $186.21	Professional		$74.13	$125.89	$186.21
United Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $1,659.59 / $3,548.13	Facility		$501.19	$1,659.59	$3,548.13
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $125.89 / $234.42	Professional		$72.44	$125.89	$234.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $91.20 / $138.04	Professional		$47.86	$91.20	$138.04